RELIAS MEDICAL SURGICAL TELEMETRY EXAM 2024 TEST BANK COMPLETE 180 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ / NURSING - Knoowy (2024)

Your inserting a urinary catheter into a male patient. As you
inflate a balloon, the patient complains of discomfort what is
the best action? - ...ANSWER...Aspirate the fluid, advance the
catheter farther, then re-inflate the balloon
When assessing a patient, you notice crepitus on the right
upper shoulder. You notify the physician and anticipate which
diagnosis? - ...ANSWER...Subcutaneous emphysema
Your patient continues to pull at their IV site located in their
left forearm despite verbal reminders and increased
observation. The nursing assistant recommends using soft
mitt restraints on the patient. What is your recommendation? -
...ANSWER...Request an order for soft mitts as they are the
least restrictive
Your patient was admitted for a hypertensive crisis and has a
history of HTN, Parkinson's disease, depression, and alcohol
use. On his second hospitalized day, you notice he is more
anxious and restless than his baseline. What would be your
FIRST nursing intervention? - ...ANSWER...Ask the patient when
his last drink of alcohol was.
You are providing patient education to a patient prior to
administering IV Protonix.... When there is no history of GERD -
...ANSWER...Protonix is given as G.I. prophylaxis to prevent
stress ulcers
The patient has a morphine PCA post operatively. On rounding
you notice respirations at eight per minute O2 saturation of
82%. What medication would be given in the situation? -
...ANSWER...Narcan
Your patient is 4 hours post open appendectomy and has not
voided yet. You note his lower abdomen is distended. What
should you do NEXT? - ...ANSWER...Perform a bladder scan
A patient with peritonitis presents with tachycardia,
hypotension, and dehydration. What other assessment finding
would you anticipate as part of your physical assessment? -
...ANSWER...Severe abdominal pain or rebound tenderness
What is the EARLIEST sign indicating increased intracranial
pressure (ICP)? - ...ANSWER...Level of consciousness
In addition to pain, pallor, and pulselessness, a neurovascular
assessment also includes checking for: -
...ANSWER...Paresthesia and paralysis
You received a report on a patient that sustained a right
hemisphere CVA 48 hours ago. What do you expect the patient
to exhibit? - ...ANSWER...Left sided weakness of the leg, arm,
and face.
You are ordered to give digoxin (Lanoxin). Your patients vital
signs are: BP 130/70, Temp 97.9F, HR 52, RR 16, O2 Sat 100% on
room air. What should you do NEXT? - ...ANSWER...Hold digoxin
(Lanoxin) and call the provider
You were caring for a patient who is 18 hours postop after a
right BKA a. They report sudden chest pain pulse ox at 86%.
The patient may be experiencing: - ...ANSWER...Pulmonary
embolism
Cardiac strip - ...ANSWER...Unable to determine
At 0500, you know your patient to be diaphoretic, clammy, and
their hands are shaking. The patient's blood sugar is currently
60. Which of the following is the most appropriate intervention
- ...ANSWER...Have the patient drink 120 ML's of orange juice
- ...ANSWER...Ventricular tachycardia
- ...ANSWER...Normal sinus rhythm
Which of the following food items would you question in the
menu of your patient who is diagnosed with celiac disease? -
...ANSWER...Wheat bread
A postoperative laparoscopic appendectomy patient is
receiving morphine PCA for pain findings with alert you to the
potential of a narcotic overdose? - ...ANSWER...A respiratory
rate of 8 breaths per minute
- ...ANSWER...Paced rhythm
Your patient was admitted with severe dehydration. Which of
the following orders would you question - ...ANSWER...KCI 40
mEq IV push STAT
What is the first sign of increased intracranial pressure? -
...ANSWER...Change in LOC
A patient suddenly complains of new onset of chest pain. The
doctor is suspecting a possible?... What is most likely to be
ordered? - ...ANSWER...Morphine Duramorph, oxygen, nitrates,
Aceticsalicylic acid, bayer buffered aspirin
The Glasgow, scale ranges from: - ...ANSWER...3 to 15
You deserve the nurse aid removing her gloves and
immediately using alcohol hand sanitizer in a room with a
patient who has C-Diff. What education should you provide to
the nurse aide - ...ANSWER...And washing with soap and water
is mandatory because alcohol based hand sanitizers do not kill
C-diff
Heart rate - ...ANSWER...80
Which of the following assessment findings should you report
immediately to the physician for a patient who just had a
bronchoscopy and biopsy? - ...ANSWER...Sputum with streaks
of blood
NOT: increased salivation
Your patient was just returned from surgery with a JacksonPratt JP drain in place which of the following is the best
nursing action? - ...ANSWER...Compress the drain, then plug
the bulb to establish suction
Patient is admitted for shortness of breath. Do you notice the
spouse adjusting the oxygen on the wall and she states "she
always takes care of my husband" what would be an
appropriate response? - ...ANSWER...Educate the spouse on
oxygen use as a medical device in the hospital
Deposition has ordered for your patience to begin a 24 hour
urine collection. Your patient voids for the first time two hours
after the orders received. What should be done with this urine
sample? - ...ANSWER...Discarded, then begin the 24 hour
collection
Which of the following lab values would you expect to see in a
patient diagnosed with?.... - ...ANSWER...Lipase - 196
You were caring for a patient admitted with abdominal pain.
Your patient has a bowel movement and you know dark tarry
stool what would be the diagnosis? - ...ANSWER...Upper G.I.
bleed
Your COPD patient is complaining of wheezing and increased
shortness of breath - ...ANSWER...Assess your patient for a
change in condition
What information is vital for you to know prior to administering
an ordered dose of digoxin - ...ANSWER...Heart rate
Your patient has been diagnosed with a hemorrhagic CVA -
...ANSWER...Heparin infusion per pharmacy protocol
A 56-year-old man has an acute onset of shortness of breath,
chest pain, apprehension, rapid pulse, cough with bloody
sputum, diaphoresis, and syncope. The symptoms are
indicative of: - ...ANSWER...Pulmonary embolism?
NOT: tuberculosis
You're reviewing the menu list of a patient on Warfran what
food should they not eat? - ...ANSWER...Spinach
Which of the following issues should be reported up the chain
of command - ...ANSWER...A coworker arriving to work under
the influence of alcohol
You're providing discharge instructions to a CHF patient. -
...ANSWER...Increase shortness of breath
cardiac rhythm - ...ANSWER...V-Tach
Which of the following electrolyte value should be Addressed
immediately by the nurse - ...ANSWER...Potassium 2.5 mEq/L
Which of the following medication may cause urine
discoloration - ...ANSWER...Rifampin
Calculate the 12 hour intake for a patient that has received the
following during your shift: normal saline 750 ML, 24 ounces of
sprite, Levaquin 50 ML, 650 ML urine in Foley catheter -
...ANSWER...1520
When caring for a patient experiencing a tonic clonic seizure,
the most appropriate nursing intervention is: -
...ANSWER...Protecting the patient's head and extremities from
contact with surrounding objects
You went to the room of a 58-year-old female. You find that
the patient's cardiac monitor shows asystolye, what should be
your first action? - ...ANSWER...Assess the patient
Not: start CPR
Didn't nurse ask you about the typical signs and symptoms o

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• Level:University
• School:Chamberlain College Of Nursing
• Course:NURSING

• Document

• Section:Examinations
• Made on:06-28-2024
• Type:.pdf
• Pages:25
• Language:English